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Compare · Sleeve and bypass

Gastric sleeve vs gastric bypass

The two main weight loss operations in Ireland, side by side, and how surgeons choose between them.

The short answer

Both are keyhole operations with similar hospital stays. A sleeve removes about 80% of the stomach and leaves the bowel alone; a bypass makes a small pouch and reroutes food past part of the bowel. A bypass usually gives a little more weight loss and helps acid reflux and type 2 diabetes; a sleeve is simpler and needs slightly less vitamin care. A sleeve costs about €6,500 to €10,000 in Ireland, a bypass about €7,500 to €12,600.

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See where your BMI sits against the usual criteria, what it costs in Ireland and what the HSE, insurance and tax relief can do. A surgeon always makes the final call.

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Do you have any of these?

Tick all that apply. These are the conditions surgeons look for at a BMI of 35 to 40.

What have you tried before?

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Which option are you looking at?

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How would you like to go about it?

Your result explains the cost and the wait for each route.

When, and where are you?

The clinic uses your county to plan consultations and check-ups near you.

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One Irish clinic gets your enquiry, nobody else. They contact you to arrange a consultation with a surgeon. Nothing is booked unless you say yes.

Thank you

Your enquiry is on its way to one Irish clinic. Here's what happens next:

  1. Today. We pass your answers to one clinic whose bariatric surgeons are on the Medical Council's Specialist Register. No one else gets them.
  2. Usually within two working days. The clinic rings or texts you to arrange a first consultation.
  3. At the consultation. A surgeon and the team assess you, explain your options and give you a written quote. Nothing is booked unless you say yes.

Changed your mind? Email hello@gastricsleeve.ie and we'll delete your enquiry and tell the clinic.

Side by side

Gastric sleeveGastric bypass
What's doneAbout 80% of the stomach removedSmall pouch joined to the small bowel
Typical weight lossUp to 25 to 30% of body weightUp to 30 to 35%
Acid refluxCan get worseUsually gets better
Type 2 diabetesOften improvesOften improves, sometimes more strongly
VitaminsFor lifeFor life, with more to watch
Dumping after sugary foodLess commonCommon
ReversibleNo (can be converted to a bypass)Rarely
Hospital stay1 to 3 days1 to 3 days
Cost in Ireland€6,500 to €10,000€7,500 to €12,600

Weight loss over 12 to 24 months as reported by an NHS bariatric unit; hospital stay from the HSE.

A doctor and a patient talking across a desk in a consulting room

How surgeons choose

Your surgeon will weigh up your BMI, your reflux, your diabetes, any previous operations, the medicines you take (some are absorbed less well after a bypass), and how you feel about each operation. A few rules of thumb:

  • Bad reflux or a hiatus hernia points towards a bypass.
  • Type 2 diabetes is often a reason to consider a bypass.
  • Needing medicines that must be absorbed reliably, or wanting to keep the bowel untouched, can point to a sleeve.

Questions to ask

  • Which do you recommend for me, and why?
  • How many of each do you do a year?
  • What does my reflux mean for a sleeve?
  • What follow-up is in the price, and who do I ring at night in the first weeks?

Questions people ask

Which is safer, a sleeve or a bypass?

Both are established keyhole operations with similar short-term safety. They differ in the long-term issues: reflux after a sleeve, and vitamin loss, dumping and internal hernia after a bypass.

Which gives more weight loss?

A bypass, by a little on average. An NHS bariatric unit reports up to 25 to 30% of body weight for a sleeve and up to 30 to 35% for a bypass.

Can I have a sleeve and later a bypass?

Yes. Converting a sleeve to a bypass is the most common revision operation, usually for reflux.

Read next

Sleeve gastrectomy explainedWhat the operation does, the weeks before it, what happens on the day and the…Gastric bypassThe Roux-en-Y bypassMini gastric bypassA one-join bypass

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